Pediatric Brain Tumor Program

Pediatric brain tumors are the second most common cancer in children, with approximately 2,500 to 3,500 brain tumors diagnosed in the United States each year.

Through the collaborative efforts of The University of Texas MD Anderson Children’s Cancer Hospital, Children’s Memorial Hermann Hospital and affiliated physicians from the McGovern Medical School at UTHealth, advances are being made in the treatment and survival of patients with brain and spinal cord tumors.

Pediatric Brain Tumor Trials

Infusion of 5-AZA Pilot Study

The Children’s Neuroscience Center has a new brain tumor trial that is open to qualified participants. The research study is being conducted by David Sandberg, M.D., Professor and Director of Pediatric Neurosurgery at McGovern Medical School at UTHealth and Children’s Memorial Hermann Hospital.

The study is called “Infusion of 5-Azacytidine (5-AZA) into the Fourth Ventricle or Resection Cavity in Children with Recurrent Posterior Fossa Ependymoma: A Pilot Study.” It is open to patients who are age 1 to 21 years old with recurrent ependymoma that originated in the posterior fossa of the brain.

The study employs a novel means of treating ependymoma brain tumors that originate from the fourth ventricle: infusion of a chemotherapy agent directly into the fourth ventricle rather than systemic intravenous delivery. The agent being infused, 5-AZA, has never been infused into the brain in humans but has been shown to effectively kill ependymoma cells in the laboratory. There will be no simultaneous systemic chemotherapy.

Combination Intraventricular Chemotherapy Pilot Study

The Children’s Neuroscience Center has a new brain tumor trial that is open to qualified participants. The research study is being conducted by David Sandberg, M.D., Professor and Director of Pediatric Neurosurgery at McGovern Medical School at UTHealth and Children’s Memorial Hermann Hospital.
The study is called “Combination Intraventricular Chemotherapy Pilot Study: Methotrexate and Etoposide Infusions into the Fourth Ventricle or Resection Cavity in Children with Recurrent Posterior Fossa Brain Tumors.” It is open to patients who are age 1 to 21 years old with recurrent medulloblastoma (PNET), recurrent ependymoma, and recurrent atypical teratoid/rhabdoid tumors involving the brain and/or spine.

The study employs a novel means of treating malignant tumors that originate from the fourth ventricle: infusion of two chemotherapy agents directly into the fourth ventricle rather than systemic intravenous delivery. There will be no simultaneous systemic chemotherapy.
This study is listed at ClinicalTrials.gov, NCT #02905110, under “Brain Tumor Recurrent.” If you would like additional information about this study, please contact Bangning Yu, M.D., Ph.D., by email at Bangning.Yu@uth.tmc.edu or call (713) 500-7363.

Phase I Dose-Escalation Trial

A phase I dose-escalation trial is now open to qualified participants at Children’s Memorial Hermann Hospital. The trial is the only study in the world investigating the direct administration of methotrexate into the fourth ventricle of the brain for the treatment of children with recurrent malignant fourth ventricular brain tumors.

The clinical trial is led by David Sandberg, M.D., FAANS, FACS, FAAP, director of pediatric neurosurgery at Children’s Memorial Hermann Hospital, the Memorial Hermann Mischer Neuroscience Institute at the Texas Medical Center, and the McGovern Medical School at UTHealth. Dr. Sandberg has pioneered the use of direct infusions into the fourth ventricle of the brain to treat children with recurrent malignant brain tumors in this location. A pilot clinical trial completed in August 2015 demonstrated that some patients with recurrent medulloblastoma experience a beneficial anti-tumor effect both within the fourth ventricle and at distant sites.

Delivering chemotherapeutic agents directly to the site of disease is particularly advantageous for children because it enables high drug concentrations at the site of disease origin while minimizing the side effects of chemotherapy by decreasing systemic drug exposure.
To learn more about the trial, contact Bangning Yu, M.D., Ph.D., by email at Bangning.Yu@uth.tmc.edu or call (713) 500-7363.

How to Qualify

Please contact Bangning Yu, M.D., Ph.D., in the Division of Pediatric Neurosurgery at McGovern Medical School for qualification information regarding Phase I Study of Methotrexate Infusion into the Fourth Ventricle in Children with Recurrent Malignant Fourth Ventricular Brain Tumors.

Management of Pediatric Brain Tumors

Knowing the signs

Brain tumors in children are often very different from those in adults, in cell type, presentation and responsiveness to treatment. Because a child’s brain is still developing, it is important for a child or adolescent to receive diagnosis and treatment from a physician team specializing in pediatric brain tumors.

Tumors present in a variety of ways depending on their location in the brain. The most common signs and symptoms are headache and vomiting due to elevated intracranial pressure. In infants and young children, irritability or a fontanelle that is fuller than normal may signal elevated intracranial pressure. Other signs and symptoms may include:

Motor weakness

Sensory changes

Personality changes

Vision changes

Speech problems

Endocrine disorders

Unsteady gait

Difficulty with muscle control

Lethargy

Seizures

Teaming together to treat brain tumors in children and adolescents

The Pediatric Brain Tumor Program brings together a team of experts affiliated with Children’s Memorial Hermann Hospital and MD Anderson Children’s Cancer Hospital to serve physicians, patients and families with new and advanced ways to diagnose and treat childhood brain tumors.

The pediatric brain tumor team includes board-certified specialists in:

The pediatric brain tumor team’s approach to treatment

Physicians with the Pediatric Brain Tumor Program partner with patients and families to deliver the best treatment tailored to children with brain and spinal tumors. In addition, the patient’s pediatrician will stay updated throughout the child’s care.

Many physicians affiliated with Children’s Memorial Hermann Hospital are faculty at McGovern Medical School at UTHealth. The affiliated physicians from McGovern Medical School consults with patients at UT Physicians clinic with all advanced treatments provided at Children’s Memorial Hermann Hospital.